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April 1, 2009 > Stroke Rehabilitation: The Answer to Improved Quality of Life

Stroke Rehabilitation: The Answer to Improved Quality of Life

Seminar Will Explore Often Overlooked Effects of Stroke

A stroke happens suddenly, and for the most part, without warning. One day you could be doing all the things you take for granted - getting dressed, mowing the lawn, talking to a neighbor and going to work. After a stroke, even the smallest tasks could become a struggle. Because a stroke attacks brain function, stroke survivors often find themselves unable to perform many basic activities of daily living.

"You can have a fairly serious heart attack and still have a pretty good quality of life," according to Doug Van Houten, R.N., clinical coordinator of Washington Hospital's Stroke Program. "Maybe you have to take the elevator instead of the stairs or you get winded more easily or you might have occasional chest pains. But when you have a stroke, you may not be able to speak or walk. You might not understand what's being said to you. You might look different or not be able to carry a conversation. Or you could be incontinent. Usually people have more than one thing to overcome after a stroke. I'd much rather have a bad heart attack than even a mild to moderate stroke."

The best bet for making improvement to faculties impaired by stroke, including speech and mobility, is rehabilitation. This is the stage of stroke care after a patient receives acute treatment and takes initial steps in the hospital, Van Houten says.

On Monday, April 6, from 12 to 2 p.m., Van Houten and a member of the Washington Hospital Medical Staff will present a seminar focusing on acute stroke management and what happens during acute rehabilitation and chronic care. The lecture is part of Washington Hospital's Stroke Education Series.

"During this talk, I'm going to try to talk a little more about some of the things we don't always have a chance to review, including the psychological and social aspects of having a stroke," Van Houten says. "I really do want to give the message that rehab is how you get your life back in order. Stroke survivors wouldn't have so many social and psychological issues, such as depression, if patients were able to overcome the deficits associated with stroke."

The rehabilitation process begins almost immediately after someone comes to the hospital for treatment of stroke. After the stroke team does all it can to reverse the effects of the stroke using various tools, such as clot-busting medications and stenting of blood vessels, then the rehabilitation professionals, such as speech and occupational therapists, take over.

Van Houten calls these professionals the "unsung" heroes of stroke care.
"The first step is we try to get patients speaking more clearly," Van Houten says. "We start working on their ability to perform activities of daily living and mobility and then patients move on to acute rehab, which is where they are medically stable and now they can work eight hours a day on getting better."
Van Houten says he won't sugarcoat the recovery process. Stroke rehabilitation is hard work, and much of the responsibility falls on the patient, especially as far as staying motivated even when things get tough.

"Recovery isn't a short, easy process," he points out. "I show a video of a man who is in a wheel chair for three years after suffering a stroke before he learns to walk again. The good news is if you're really determined, you can continue to take strides."

Depression and social isolation, which tend to feed on one another, are two of the major psychological consequences of stroke.

"I'm always generalizing when I talk about stroke, but it is different for every person," Van Houten says. "I've had patients with very light strokes or bad strokes, and some go home with barely any problems. Then I have patients that have had moderate to severe strokes who are really disabled and many patients who have died.

"It's hard to speak about these patients from a general standpoint, because they can be so different. That's one of the reasons that I'm interested in introducing the emotional and psychological aspects of recovery within the physical domain of care. The fact is that when you're outlook drops and everything looks really bad your ability to cope and get better is really inhibited."

Van Houten says the ways to overcome the major hurdles that come with stroke include: seeking social interaction in the form of a support group, working hard at the recovery process, finding new ways of getting back to enjoyable activities and maintaining a positive outlook.

"I think if stroke survivors can stay on course and follow through with all the rehab they can get, then in many cases there is a good chance for improvement," he says. "The important thing is that you don't stay home and just watch TV. After you've had a stroke, get out and keep experiencing life."

Van Houten says it is not only important for stroke survivors to learn more about the recovery process, but it is also vital for their family members and caregivers, who are most often a spouse.


Knowledge makes the difference

Because stroke often happens with no prior warning, it's important to learn more about it before you suffer a stroke. The single greatest risk factor for stroke is having already suffered one. By learning about the disease process, Van Houten says, you can help reduce your chances of suffering a stroke by making important lifestyle choices and knowing when to call 9-1-1 at the first signs of stroke.

Join Van Houten as he invites stroke survivors, their caregivers and family members to learn more during the next seminar in the Stroke Education Series.
To learn more about the Stroke Support Group at Washington Hospital, call (510) 745-6525 or visit www.whhs.com, click on "Services & Programs," select "Taylor McAdam Bell Neuroscience Institute," and choose "Stroke Program" from the drop-down menu.


Get the Facts About Stroke Treatment and Recovery

WHAT: Stroke Education Series
TOPIC: Acute Management of Stroke/Chronic Care-Rehab
WHEN: Monday, April 6, 12 to 2 p.m.
WHERE: Conrad E. Anderson, M.D. Auditorium, 2500 Mowry Ave. Fremont
CALL: (800) 963-7070 to register

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